Recognizing Strongyloides hyperinfection

Strongyloides stercoralis hyperinfection syndrome is an uncommon opportunistic infection that can present in immunosuppressed patients years after exposure. Disseminated infection can result in multisystem organ involvement culminating in sepsis and respiratory failure. Screening and treatment of at-risk persons before the initiation of immunosuppressive therapy may prevent this frequently fatal syndrome. We present a case of necrotizing myositis complicated by diffuse alveolar hemorrhage and sepsis following corticosteroid therapy; the patient had Strongyloides hyperinfection.